{"id":54548,"date":"2021-08-25T08:19:49","date_gmt":"2021-08-25T12:19:49","guid":{"rendered":"https:\/\/www.med.unc.edu\/medicine\/?p=54548"},"modified":"2023-06-06T18:13:09","modified_gmt":"2023-06-06T22:13:09","slug":"telemedicine-in-prison-allows-continued-care-shows-positive-patient-provider-experiences","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/medicine\/news\/telemedicine-in-prison-allows-continued-care-shows-positive-patient-provider-experiences\/","title":{"rendered":"Telemedicine in Prison Allows Continued Care, Shows Positive Patient-Provider Experiences"},"content":{"rendered":"

For incarcerated individuals whose health depends on access to specialized health care, telemedicine can ensure more timely access, as well as a better experience. Early in the pandemic, UNC Health, the UNC School of Medicine, and the North Carolina Department of Public Safety (DPS) partnered to develop the capabilities for providing telemedicine services to the incarcerated population. A cross-sectional analysis<\/a> published last week in JAMA Network Open identifies the merits of using telemedicine for continuing specialty care during the COVID-19 pandemic. A survey also shows telemedicine was well received by patients, nursing staff and providers.<\/p>\n

\"Dorn-Edson-Khairat\"<\/a>
Spencer Dorn, MD, MPH, MHA, Barbara Edson, and Saif Khairat, PhD, MPH<\/figcaption><\/figure>\n

The partnership to support prisons included Barbara Edson<\/a>, the executive director of the UNC Virtual Care Center; Terri Catlett<\/a>, director of healthcare administration for the NC Department of Public Safety (DPS); Saif Khairat<\/a>, PhD, MPH, associate professor of the School of Nursing and the Carolina Health Informatics Program; and Spencer Dorn<\/a>, MD, MPH, MHA, professor and vice chair for care innovation in the Department of Medicine.<\/p>\n

\u201cDuring the pandemic, incarcerated individuals have been largely unable to move between prisons and healthcare facilities. This has severely restricted their access to specialty care,\u201d said Dorn.<\/p><\/blockquote>\n

It was this restriction that spurred DPS, UNC Health, and UNC School of Medicine to rapidly implement a recent legislative requirement for incarcerated individuals to receive specialty care via telemedicine. UNC Health and DPS already had a longstanding relationship. In April 2012, a study by the UNC Kenan-Flagler Business School and UNC Health identified the first opportunities for telehealth.\u00a0In 2019, the NC Legislature passed House Bill 106, calling for improvements in health care reimbursements and a telemedicine pilot with two prison locations, one in the east and one in the west, to be completed by December 2020.<\/p>\n

\u201cSo many dedicated people made this possible, including the frontline prison staff, dozens of UNC physicians and advanced practice providers, and the North Carolina legislature, who presciently embraced telemedicine to enhance care for this disadvantaged population,\u201d said Dorn.<\/p>\n

Implementing Telemedicine<\/h3>\n

Key steps included procuring and implementing telemedicine software and equipment, developing scheduling and clinical workflows, and training and credentialing DPS administrative staff, nursing staff and UNC clinicians to provide care via telemedicine across 55 North Carolina prisons.<\/p>\n

Altogether, there were 3,438 patient visits from June 1 – November 30, 2020, and 8,968 visits through July 31, 2021. In addition to medicine subspecialties, the Departments of Psychiatry, Urology and Surgery provided services. Without telemedicine, many people would not have been able to receive care during the pandemic.<\/p>\n

Patient and Provider Feedback<\/h3>\n

Surveys show 94% of patients reported the telemedicine experience was positive. Among providers, 86% were satisfied with the telemedicine visits, and 90% felt comfortable using telemedicine. Among tele-presenters, 94% were satisfied using telemedicine, and 93% were comfortable using telemedicine.<\/p>\n

\u201cThis study exemplifies a forward-thinking approach to caring for populations at high risk,\u201d Khairat said, first author of the analysis. \u201cThe novelty of delivering specialty care via telemedicine during the pandemic was an innovative way to reduce the risk of exposure to the virus, which was highly valued by patients and providers.\u201d<\/p><\/blockquote>\n

The next step will be to understand the factors driving adoption or resistance to telemedicine use among patients and providers, through surveys that assess the user experience.<\/p>\n

Healthcare in Prisons<\/h3>\n

To understand the appeal for telehealth programs, it is important to understand what care for individuals looks like without it. Historically, most incarcerated individuals have had to leave their prison facility to receive care at a local or regional healthcare facility, such as UNC Medical Center. But this process is expensive, logistically challenging, may fragment care, and poses security risks.\u00a0By keeping them at their local facility, telehealth is more efficient, lower cost, and more secure.<\/p>\n

Among providers, there may also be uncertainty about how to manage appointments with incarcerated people. Telemedicine enables prisons to connect individuals with providers they wouldn\u2019t otherwise have access to, and in conditions that can be more private, and perhaps more humane, compared to what they might experience when escorted to an appointment at a community facility.<\/p>\n

Read the analysis<\/a> published in JAMA Open Network.<\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

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